Correspondence to Arch Orthop Trauma Surg 139(6):807816, Fayad LM, Parellada JA, Parker L, Schweitzer ME (2003) MR imaging of anterior cruciate ligament tears: is there a gender gap? 2023 Feb;19(1):107-112. doi: 10.1177/15563316221092320. 2004-09-01T13:26:27Z A thorough understanding of knee injury patterns and their mechanisms may help achieve more accurate assessment of injuries [8]. A total of 1000 patients were enrolled in this study, including 500 patients with ACL injuries who assigned to experimental group and 500 patients with meniscal tear (MT) who allocated to control group. Bookshelf Bone marrow oedema may also show delayed enhancement following administration of gadolinium DTPA. Disabling symptoms are often prolonged. The site is secure. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Skeletal Radiology (2008) ISBN:0323076211. 2016 Nov;32(11):2331-2341 Google Scholar, Wierer G, Simetinger T, Hudelmaier M, Moroder P, Hoffelner T (2020) Fate of the lateral femoral notch following early anterior cruciate ligament reconstruction. *Other cause include fall while getting down from bus (1 case), fall while jumping (1 case), fall while getting downstairs. endobj 21033-6-01). 2022 Dec;30(12):1647-1657. doi: 10.1016/j.joca.2022.08.006. Oedema or interisital fluid within marrow extracellular space similar to free fluid shows long T1 and T2 decay characteristics and appear hypointense on T1 and hyperintense on T2W. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. The posteromedial corner of the knee is a capsuloligamentous complex in the posterior aspect of the medial compartment. Mandalia V, Henson JH. No fractures were present on x ray. PDFS Saggital: Bone marrow oedema in Intercondylar region tibia with subchondral cysts. Careers. The purpose of this review is to . 1989 Mar;170(3 Pt 1):823-9 Patterns of bone bruise in knee injury. Am J Sports Med. Unauthorized use of these marks is strictly prohibited. In present study clip injury pattern is noted in 39 cases (28.6%). Bone bruising; Knee hyperextension; MRI. J Bone Joint Surg Am. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. volume143,pages 927934 (2023)Cite this article. PubMed Central Materials and methods: 2019. The authors declare that they have no conflict of interest. By analysing bone marrow contusion pattern, type/mode can be determined in most of the cases. Terzidis et al., 20 conducted a study on acute knee injuries in 255 athletes with acutely injured knees, 219 MRIs were done within the first month after the injury and 36 within two to four months [13]. Green DW, Hidalgo Perea S, Kelly AM, Potter HG. Grade II ACL tears represent intraligamentous injury and an increase in ligament length. Bone marrow contusion was noted in 71 cases out of 255 cases (27.8%). In suspected ACL injury, bone marrow contusion may not be necessarily present. 1996 Jan;198(1):205-8 Biomechanical and anatomical assessment after knee hyperextension injury. A knee contusion can range from mild to severe. Posteromedial Tibial Bone Bruise After Anterior Cruciate Ligament Injury: An MRI Study of Bone Bruise Patterns in 208 Patients. Characteristic magnetic resonance imaging (MRI) findings often lead to the diagnosis. They can be used to diagnose ACL injuries. Arch Orthop Trauma Surg 140(12):20132020, Article Looking for more information? Expansive network access, savings and no red tape An absolute win-win foreveryone! According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). The .gov means its official. At the time the article was created Henry Knipe had no recorded disclosures. Most common location of marrow oedema in pivot shift pattern was posterolateral tibial plateau and lateral femoral condyle and medial tibial condyle and medial femoral condyle in 31 cases (39.7 %) [Table/Fig-9]. Br J Sports Med. bone bruises on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. This case demonstrates a hyperextension knee injury consisting of. Knee Surg Sports Traumatol Arthrosc 26(5):13991405, Lodewijks P, Delawi D, Bollen TL, Dijkhuis GR, Wolterbeek N, Zijl JAC (2019) The lateral femoral notch sign: a reliable diagnostic measurement in acute anterior cruciate ligament injury. 3. 98 0 obj Bone contusion of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee. Please enable it to take advantage of the complete set of features! 2012;2 (5): 398-402. Google Scholar, Kanakamedala AC, Burnham JM, Pfeiffer TR et al (2018) Lateral femoral notch depth is not associated with increased rotatory instability in ACL-injured knees: a quantitative pivot shift analysis. The saggital plane was primarily used to evaluate the bone marrow oedema which was confirmed on coronal images. Google Scholar. Become a Gold Supporter and see no third-party ads. To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. no financial relationships to ineligible companies to disclose. Minor focus of edema in the anterior aspect of the lateral femoral condyle. The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. Patient was placed in supine position with knee externally rotated 10-20 degree 21. Graf BK, Cook DA, De Smet AA, Keene JS. Objective: FOIA This study was approved by the ethical committee of Beijing Tsinghua Changgung Hospital (No. Fill out the form below and a representative will be in touch. Bone marrow contusion was noted in lateral femoral condyle in 15 cases (38.5%) and involving lateral and medial femoral condyle in 24 cases (61.5%). Radiology. Accessibility 31 0 obj Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. endobj Sanders classified bone marrow contusions in five different patterns as: Clip injury, Pivot shift injury, Dashboard injury, Hyperextension injury, and Lateral patellar dislocation [8]. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. -, Radiology. Our team of experienced agents will hand hold the member through theentireprocess. 2014;55(8):9618. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. MeSH Ali, A.M., Pillai, J.K., Gulati, V. et al. Sports Med. Contusions of both surfaces of the joint are known as kissing contusions. khloe kardashian hidden hills house address. The lateral femoral notch sign following ACL injury: frequency, morphology and relation to meniscal injury and sports activity. PDFS Saggital: Bone marrow oedema at proximal tibia in Dashboard injury. Correlation between type or mode of injury and patterns of bone marrow oedema was determined using p-value and chi-square method. Injury to the Meniscofemoral Portion of the Deep MCL Is Associated with Medial Femoral Condyle Bone Marrow Edema in ACL Ruptures. PubMed Central 1 Kacey Court, Suite 100, Mechanicsburg, Pa, 17055. 2 cases (50%) are hyperextension injury with kissing contusion at anterior aspect of proximal tibia and distal femur caused due to hit by car in RTA. While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. These findings are comparable to Arndt et al., who conducted a study in MR diagnosis of contusion of knee in < 6 weeks and described bone marrow contusion in 23 cases out of 51 cases (45.1%). Archives of Orthopaedic and Trauma Surgery, https://doi.org/10.1007/s00402-022-04366-9. Out of 200 patients, 32 were women (16%) and 168 men (84%). Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. J Bone Joint Surg Am. Twenty-five patients were identified (median time from injury to MRI = 24 days). High signal well within the intercondylar notch with a partial-thickness tear inferiorly of the femoral insertion of the posterior cruciate ligament (best see on the coronal sequence). 2022 Oct;30(10):3508-3514. doi: 10.1007/s00167-022-06970-z. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the . official website and that any information you provide is encrypted The 32 bone contusions (16 kissing contusions) were located as follows: lateral femoral condyle (n = 14; 8 type I, 6 type II); lateral tibial condyle (n = 9; 3 type I, 1 type II, 5 type III);. Medial and lateral meniscal tears usually involving the . 8600 Rockville Pike the contents by NLM or the National Institutes of Health. 2019 Nov;27(11):3633-3637. doi: 10.1007/s00167-019-05490-7. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Associated Soft tissue injuries include ACL and medial meniscus [8]. Biomechanical Approach to MRI of Acute Knee Injuries. Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. Rangger C, Klestil T, Kathrein A, Indester A, Hamid L. Influence of magnetic resonance imaging on indications for arthroscopy of the knee. We're here to help! Davies NH, Niall D, King LJ, Lavelle J, Healy JC. T1W Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. In this case, patient has had a hyperextension external rotation injury of the knee as evidenced by the kissing bone marrow contusions in the anterior aspect of the lateral femoral condyle (LFC) and the lateral tibial plateau. Kapelov RS, Terris LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. Pure passive hyperextension of the human cadaver knee generates simultaneous bicruciate ligament rupture. The purpose of this review is to illustrate the MRI findings of lateral patellar dislocation and concomitant injuries, such as kissing contusions of the medial patella and lateral femoral condyle; osteochondral and avulsion fractures; and injuries of the medial patellofemoral ligament/retinacular complex. Type / Mode of injury in Clip injury pattern. Pivot shift pattern is most common contusion pattern and the most common type/mode of injury is sports related injury. Although bone marrow oedema is nonspecific and has a similar appearance in inflammatory and neoplastic disorders, a traumatic cause is usually obvious on the basis of the location of bone marrow oedema and the presence of other trauma related findings. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 2008;36:804. 2005;118(1209):U1301. https://doi.org/10.1007/s00256-017-2754-y, DOI: https://doi.org/10.1007/s00256-017-2754-y. The values of notch depth in patients who had ACL rupture concomitant lateral MT injuries and medial collateral ligament (MCL) injuries were 1.120.64 and 1.230.74mm, respectively, which were significantly higher than those in patients with only ACL injury (0.890.49mm) (P<0.05). This case demonstrates a hyperextension knee injury consisting of partial posterior cruciate ligament tear proximal tibia epiphysis bone contusion and minor "kissing contusion" of the lateral femoral condyle posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE. Diagnosis of bone marrow oedema following traumatic event prompt a closer inspection for lesions such as ligamentous and meniscal tears. and transmitted securely. Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. <>stream Felt a "popping" sensation after landing on a straightened knee. sharing sensitive information, make sure youre on a federal Kim SY, Spritzer CE, Utturkar GM, Toth AP, Garrett WE, DeFrate LE. J Clin Diagn Res. In patients with bone marrow contusion, 14 were women (10.1%) and 124 were men (89.9%). Accessibility MR feature of bone bruising reflects increase in water content in marrow cavity as a result of haemorrhage, therefore water sensitive sequence like fat saturated T2W, PD weighted image or STIR are used [1,11,12]. Hong CK, Lin YJ, Cheng TA, Chang CH, Hsu KL, Kuan FC, Su WR. This site needs JavaScript to work properly. Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. HHS Vulnerability Disclosure, Help 2011 Aug 17;93(16):1510-8. doi: 10.2106/JBJS.J.01320. Call Us Today! Google Scholar. Skeletal Radiol 44(3):385391, Herbst E, Hoser C, Tecklenburg K et al (2015) The lateral femoral notch sign following ACL injury: frequency, morphology and relation to meniscal injury and sports activity. Eur J Orthop Surg Traumatol. It is a rare (6.3% in this series) but significant injury, often associated with ligamentous or menisceal tears. Thank Professor Zhuozhao Zheng and my girlfriend Danyu Chen for their advice and help on this study. sharing sensitive information, make sure youre on a federal Comparison of bone contusion seen by MRI in partial and complete tears of the anterior cruciate ligament. Arch Orthop Trauma Surg 140(7):923931, Renstrom P, Ljungqvist A, Arendt E et al (2008) Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Bone bruises: MR characteristics and histological correlation in the young pig. 2021 Nov 11;6(4):e21.00069. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. Unable to load your collection due to an error, Unable to load your delegates due to an error. endobj Eur J Radiol. Surgical Strategy for Anterior Tibial Plateau Fractures in Hyperextension Knee Injuries. AJR Am J Roentgenol. In 6 cases bone marrow contusion could not be explained by various patterns. Federal government websites often end in .gov or .mil. Epub 2021 Apr 4. [11] Anterior displacement of tibia refers to increased distance from the posterior cortex of the lateral tibial plateau to the posterior cortex of the femur. Type/Mode of injury in these cases are: impact during car accident in 4 cases, fall on flexed knee while playing cricket in 1 case, while getting downstairs in 1 case and fall from bike in flexed knee in 2 cases. sharing sensitive information, make sure youre on a federal Liu ZY, Zhang JL, Liu C, Cao Q, Shen QJ, Zhao JC. This site needs JavaScript to work properly. Results: In this study 8 cases (5.7%) had dashboard injury pattern of bone marrow contusion at anterior aspect of proximal tibia. HHS Vulnerability Disclosure, Help Ready to get started? 2023 Feb;143(2):927-934. doi: 10.1007/s00402-022-04366-9. Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. [Table/Fig-10,,1111 and and12]12] show the aetiologies and location for pivot shift injury, Type /Mode of injury among dashboard injury pattern (8 cases) were - Impact from dashboard in 4 cases, fall from bike (2 cases), running downstairs (1 case) and fall while paying cricket (1 case). Epub 2022 Apr 12. This is a preview of subscription content, access via your institution. Contusions of both surfaces of the knee joint are known as kissing contusions. Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Conclusions: Radiology 184(3):855858, Dimitriou D, Reimond M, Foesel A et al (2021) The deep lateral femoral notch sign: a reliable diagnostic tool in identifying a concomitant anterior cruciate and anterolateral ligament injury. 2023-05-01T23:01:26-07:00 Knee joint is one of strongest joint in body and allows transmission of body weight to leg. PDFS Coronal: Bone marrow contusion at lateral femoral condyle and lateral tibial plateau in Pivot shift injury pattern. Compressive load causes bone marrow contusion and, if sufficient in magnitude, depressed cortical fracture. MRI Introduction Anterior cruciate ligament (ACL) injuries are among the most common sports injuries. MRI is used widespread to interpret more complex injuries. Emerg Radiol 17(6):435444, Murphy BJ, Smith RL, Uribe JW, Janecki CJ, Hechtman KS, Mangasarian RA (1992) Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? 2. Park HJ, Lee SY, Chung EC, Rho MH, Ahn JH, Kim M, et al. Careers. Acrobat Distiller 5.0.5 (Windows) Other structures are injured less frequently and have weaker associations with bone bruise distribution. Magnetic Resonance Imaging of Bone Marrow: A Review Part II. 99 0 obj bone contusion) can give clues for the mechanism and associated injuries. On MRI these injuries appears as ill defined, subchondral, reticulated or stellate region of low signal intensity on T1W and high signal intensity on T2W images [6]. The classic bone contusion includes involvement of the antero-lateral aspect of the lateral femoral condyle and the inferomedial aspect of the patella. Pivot shift injury depending on location and type/mode of injury. MRIs, plain radiographs and clinical details of these patients were reviewed. The KIS Imaging program was designed to direct patient care, through a concierge service, in which employees and employers can realize up to an 80% savings on all major imaging. J Orthop Surg Res. endobj -, Radiology. 2022 Oct 17;10(10):23259671221120636. doi: 10.1177/23259671221120636. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. PubMed Central The coronal lateral collateral ligament sign in the anterior cruciate ligament-injured knees was observed regardless of the knee laxity based on the quantitative measurements. Tax calculation will be finalised during checkout. Study was conducted between May 2014 to September 2015 with a sample size of 200 patients. Correlation between various pattern of bone marrow oedema and type/mode of injury are shown in [Table/Fig-17]. A 124(62%) had trauma in right knee and 76(38%) in left knee. PDFS Saggital: Bone marrow oedema at Lateral femoral and posterolateral tibial plateau in Pivot shift injury. 2011;197 (3): 568-77. Five patterns of bone marrow contusion was noted in 138 cases: Clip injury in 39 cases (28.3%) [Table/Fig-1a&b], Pivot shift injury in 78 cases (56.5%) [Table/Fig-2a&b], Dashboard injury in eight cases (5.8%) [Table/Fig-3], Hyper extension injury in four cases (2.9%) [Table/Fig-4], Lateral patellar dislocation in three cases (2.2%) [Table/Fig-5]. PubMed The depth of LFNS and the presence of KC were determined on MRI findings. The 32 bone contusions (16 kissing contusions) were located as follows: lateral femoral condyle (n = 14; 8 type I, 6 type II); lateral tibial condyle (n = 9; 3 type I, 1 type II, 5 type III); medial tibial condyle (n = 7; 2 type I, 5 type III); medial femoral condyle (n = 2; both type I). Other 2 cases (50%) are hyperextension with valgus component and kissing contusion at medial aspect of proximal tibia and distal femur caused due to kicking while playing football. [1] References [ edit] ^ Terzidis, I. P. (October 2004). 2000 Nov-Dec;24(6):371-80 eCollection 2021 Oct-Dec. Liu ZY, Zhang JL, Zhang T, Cao Q, Zhao JC, Li EQ, Shen QJ, Zhao BC, Zheng YC, Chen Y. Orthop Surg. Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. There were 2 cases with hyperextension injury while playing football and 2 patients attained the injury after being hit by car. doi: 10.2106/JBJS.OA.21.00069. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> Before Bone Marrow Signal Alteration in the Extremities. Herbst E, Hoser C, Tecklenburg K, Filipovic M, Dallapozza C, Herbort M, et al. Am J Sports Med. MRI of affected knee joint was done as per imaging protocol and images stored in compact disc. It also was revealed that when the optimal cut-off point of LFNS was 0.72mm (area under the curve (AUC)=81%), the values of specificity and sensitivity were 67% and 84%, respectively. Knee 27(2):414419, Yoon JP, Chang CB, Yoo JH et al (2010) Correlation of magnetic resonance imaging findings with the chronicity of an anterior cruciate ligament tear. Mechanism of traumatic knee injuries and MR findings. Knee Surg Sports Traumatol Arthrosc. [12] Vojnosanit Pregl. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Asai K, Nakase J, Oshima T, Shimozaki K, Yoshimizu R, Tsuchiya H (2020) Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain. Clin Imaging. PubMed Central 2003;37:1379. Type I lesions are most common on the lateral femoral condyle and type III on the lateral tibial condyle. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. Disclaimer. eCollection 2020 Apr. Prognosis is particularly influenced by the presence of osteoarthritis. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. Arch Orthop Trauma Surg 128(11):13131316, Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P (2004) The appearance of kissing contusion in the acutely injured knee in the athletes. Methods: Chi-square: 41.961 and p <0.001 suggests that clip injury was significantly high in fall from two wheeler and pivot shift injury was significantly higher in sports related injury. eCollection 2022 Oct. Moran J, Katz LD, Schneble CA, Li D, Kahan JB, Wang A, Porrino J, Jokl P, Hewett TE, Medvecky MJ. We describe the clinical and radiographic features of 11 athletes found to have femoral head lesions similar in MR imaging appearance to osteochondral lesions in other locations, such as the knee and ankle. A cross-section study was done on all patients reffered to Krishna Hospital, Karad for MRI knee with history of recent (< 6 weeks) knee injury. MRI of the Pediatric Knee Pediatric Imaging Review. Clipboard, Search History, and several other advanced features are temporarily unavailable. In many cases, Bone marrow contusion might have resolved at time of MRI. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries. If the knee is exposed to forces beyond its physiologic range, risk of injury to bone or soft tissue structures increases. Check for errors and try again. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. MR imaging performed in two patients with kissing contusions showed persistence of the tibial lesions. Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. official website and that any information you provide is encrypted 1989 Jun;171(3):761-6 In these 16 cases, contusion in medial compartment was noted in 2 cases (12.5%) [13]. The magnitude of the force is a major determinant of the imaging findings. Mandalia V, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. J Bone Joint Surg Am. Application of valgus load to the knee in various degree of flexion combined with external rotation of the tibia or internal rotation of the femur lead to pivot shift injury resulting in disruption of Anterior Cruciate Ligament (ACL). Twenty of the 23 patients had follow-up imaging. As a library, NLM provides access to scientific literature. Radiology 182(1):221224, Niitsu M, Kuramochi M, Anno I, Itai Y (1995) Secondary signs of anterior cruciate ligament tear at MR imaging. Language links are at the top of the page across from the title. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern. Matrix in various sequences were listed as : T1 Saggital 307 x 384, T2 Axial - 314 x 448, T2 Saggital 314 x 448, PD Saggital 307 x 384, PD Coronal 355 x 384, PDFS Saggital 288 x 384, PDFS Coronal 311 x 384, MEDIC Axial 240 x 320.
